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Evidence-Based Medicine and Shared Decision-Making are “All hat and no cattle.”

Evidence-Based Medicine and Shared Decision-Making are “All hat and no cattle.” Farmers are great people who fix problems. I grew up on a farm and wish I was solving problems, but we seem stuck.

Everyone has been saying that we need evidence-based medicine (EBM) and shared decision-making (SDM). Patients need to be better informed, better educated, and need to be more knowledgeable. Knowledge is power, they say.

Help Patients

A physician, James Madera, MD, suggested in an article that most of the modern healthcare Digital Products and medical devices are nothing more than “snake oil.”

Dr. Madara is right. So far digital health has been "All hat and no cattle." Health information technology, big data, and natural search engine language technology are not giving us what we need. You need to be able to look down on your cell phone and get a list of treatments with Treatment Scores.

The Treatment Score = the net treatment benefit for the patient. What is pictured above is a "generic example" for fictional cancer X. If your doctor had this on his/her cell phone and you had this on your cell phone, you could actually work together and do shared decision-making, because these "example" numbers, and everything behind these numbers, can be changed according to your values and preferences.

The Treatment Score = the net treatment benefit for the patient using EBM guidelines. Treatment Scores need to be produced using shared decision-making (SDM) between the patient and the physician. 

Treatment Scores use the math of medical statistics combined with the math of economics. They can be personalized.

Doctors do not have time for evidence-based medicine; they cannot keep up with the medical literature.

Patients cannot do EBM and SDM alone. They need the tools.

Treatment Scores would solve a lot of problems. I have made a list of people, and organizations, that need Treatment Scores:

1. Patients
2. Doctors
3. Nurses
4. Health reporters 
5. Health publishers
6. Patient advocates
7. Hospitals, Medical Schools, Residencies 
8. Tumor Boards
9. Non-profits advocating for patients
10. Insurance companies (worldwide)
11. Governments (worldwide) 
12. Medicare
13. Medicaid 
14. Congress - to prioritize research

Thanks for listening.

James Madara, MD, as quoted in “AMA CEO calls digital products modern-day ‘snake oil’” By Greg Slabodkin. Health data management. June 13 2016. Accessed June 20, 2016.

Always see your own licensed physician for diagnosis and treatment. Using Treatment Scores instead of a doctor can be harmful or deadly, because the underlying medical literature is always flawed in some way.

After Being Diagnosed with a Horrible Disease

After you are diagnosed with a disease, you need to ask three questions:

  1. What are the Treatments?
  2. What is the Treatment Score for each treatment?
  3. What does each treatment cost?

Healthcare should be this simple, but it isn't.

The problem for patients is that the medical literature is in a huge, dark, underground cavern containing over 29 million disorganized medical studies.

For patients, it’s difficult to get into the cave, and after getting down there the medical vocabulary is incomprehensible and the statistics are next to impossible.

Even the most highly skilled patient cannot overcome all these obstacles and the “avalanche of big data.”

Every once in a while, a physician, nurse, or health reporter enters the cave, shines a flashlight into the darkness, and comes out to properly explain a medical treatment to someone. Then, the cave goes dark again.

Treatment Scores goes into that huge dark cavern, wires it with electricity, and turns the lights on forever.